"Electronic Communication Across Provider Settings" is a planning project for Health Information Technology (HIT) improvements centered around office based electronic medical records. The outcome of the project will be an implementation plan and site preparation for software enhancements with three major goals: decrease errors through improved use of the EMR as a clinical tool; integrate clinical data; and increase access to the data. A partnership called PATH consisting of an acute care hospital, 4 rural community health centers, a community mental health center, a family medicine residency, 6 private physician practices, and a home nursing service will undertake the project. All sites run GE's Centricity EMR. Objectives will be to add secure e-mail communication among doctors, institutions, and patients; to seamlessly capture data points into and between EMR's with new user interface software and technologies; and to create a joint database capable of analyzing population trends for Ql and public health purposes.